esob

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Many years ago when I first started working as a lab tech in an army hospital, one of my duties was to assist the pathologist on autopsies. The first one I ever attended featured a lady who had died of a presumed heart attack but for whatever reason, regulations dictated that an autopsy had to be performed. I still remember the crunchy sound her artery (I think it was the carotid) made as the pathologist cut through it looking for the culprit. He found what he described to myself and 2 other young lab techs as "chicken fat" and declared it the perpetrator. We asked what caused it and he offhandedly said it was likely a life well-enjoyed that featured a diet rich in ice cream and other indulgences.

For a long time after that first experience I didn't eat ice cream, assured that the next bowl of blue bell would be the last thing I saw before I ended up the table myself :) Now I know ofc now that one scoop of ice cream isn't a heart attack in a bowl; but I do know that a lifetime of bad habits decreases both quality and quantity of life. It seems then that doctors, more than any other profession, should be acutely aware of this. Thus begs the question, why are docs not all health nuts who have ideal bmi's and live to be 120? Is it just that "once you know" its too overwhelming to try and do everything right or is it something else?
 

Mad Jack

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Doctors often don't have the time to eat properly or work out, particularly during residency, but in some specialties, even beyond. Couple that with the exhausting nature of the work, and the relatively sedentary nature of many fields, and you have a recipe for relatively poor health if one is not careful.
 

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Being a ballistics expert doesn't mean that bullets can't hit you.

Knowing how to take care of yourself is not the same thing as having the opportunity. It is a risky, stressful job with hours and conditions that are not conducive to a balanced diet, adequate exercise, uninterrupted sleep, or healthy personal relationships and leisure time.
 

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QofQuimica

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Changing behavior requires more than just knowing, and is a fairly complex and often difficult process. Being a physician doesn't somehow make it easier to change your behavior. And as others have mentioned, there's nothing inherently healthy about the work physicians do.
This.

As with accumulating wealth, being healthy is often more related to the sum total of all the little choices we make each day, as opposed to "winning the lotto," which is more the mentality with which most people (whether physicians or not) approach these issues. Delaying gratification is something physicians have to be good at in order to get through their training, but everyone has their limit. I think people often view eating as part of living the good life (and rightly so), and physicians in particular may not want to have to delay gratification or deny themselves in yet another area. Which I think also explains the spending spree that many go on once they get out of residency. The lack of concern for work-life balance in professional training is also a major issue. Even as an attending, it can be supremely difficult to get regular daily exercise and eat proper meals.

I have made some nonstandard choices to build more activity into my life (such as living close to where I work and walking to work), which I can tell you still gets me some raised eyebrows from the staff, let alone from my physician colleagues, most of whom prefer to live in ritzier areas and commute 20+ miles each way out here. But in my own experience, designing your lifestyle around your health and wealth goals is the only sustainable way to achieve them. It still astounds me when I counsel a patient on weight loss, and they rejoin with, "well, that's easy for you to say, doc. You're thin." To which I reply, "I diet and exercise every single day. The same laws of physics, chemistry, and biology apply to me as to you. If I did/ate what you do/eat, I wouldn't be thin."
 

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As mentioned above professionals have access to richer foods and don't have time to work out often lose sleep over their jobs and face a lot of stress so they are impacted by things like obesity, heart disease, ulcers and gout more than they ought.

However, regarding your tangent on autopsy and ice cream, I wouldn't put too much stock into what's a healthy type of food per se, what will lead to clogged arteries, etc.

We in medicine just recently revamped the food pyramid, throwing out decades of dietary teaching and most researchers in the area still think we don't have it quite right yet. There's new focus on things like "gluten" which was actually considered a dietary staple just a few years back. There are proponents of Atkins/South Beach, low carbs, ornish, vegan, paleo and Mediterranean diets which all somewhat conflict but all have physician proponents. We now know some cholesterol is bad except for people with certain genetic make ups, so it's likely your genes and not your cholesterol that dooms you to the cath lab. So I'd say doctors are in the same boat as everyone else in terms of not knowing what to eat. And you should enjoy your ice cream in moderation until your cardiologist tells you you can't.
 
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esob

esob

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The constantly changing landscape in food science is frustrating to say the least. Personally I've been following my own combination of an AIP and SCD diet for about 3 years now with really good success. I know that it has a lot to do with my genetic makeup however and that not everyone would respond well to it.
 

CyrilFiggis

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It's not just food. Volunteering in a ER/Trauma Center, I saw an innumerable amount of motorcycle accidents. Yet I still ride mine every chance I get. We're humans and we sometimes have a tenuous relationship with logic.

However, the one thing that I do find difficult to grasp is GPs who are themselves overweight and lecture their patience on diet and exercise. I know that they can't be enablers, but that the type of hypocrisy that the general public thrive on in their criticism of medical professionals.
 

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Once you're in med school you will learn that people relate better to doctors who are like them.

However, the one thing that I do find difficult to grasp is GPs who are themselves overweight and lecture their patience on diet and exercise. I know that they can't be enablers, but that the type of hypocrisy that the general public thrive on in their criticism of medical professionals.
 
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They have ZERO personal time and ZERO personal life.

Last year I applied to MD and go rejected. Despite having volunteer and shadow experience, I told myself I would do more and set up some regular shadowing with some specialists. After my rejection, I used a friend connection to spend 2 full days of the week shadowing specialists (in ICU and thoracic surgery) for about 6 months. Since I also had a healthcare background it made it easy to give me access and such to basically attend alll rounds / education activities / surgeries that I wanted.

Prior to this long term experience I thought I had it all figured out and that medicine was my calling. I thought I knew about all the sacrifices MDs make, the long hours, the years of training. It's what I saw every day while working as a hospital assistant. I thought I could make a great doc and really take the time for my patients and care and change the way some doctors deliver care (which I thought was in some ways flawed and attributed to their lack of investment in "really getting to the root of the problem"). Little did I know that even some of those doctors who come across as jerks, really had very good intentions which were destroyed by the state of "medicine" today.

It took this longitudinal experience, which gave me access to the resident meetings, call room conversations, complaints which made me realize this job is actually not what it's made out to be. Many specialists are in it only for the money, and most of those with good intentions are so over worked and so tired and so miserable I actually had a few residents ask me why I ever wanted to go into field. During my 6 months 7/10 of the fellows I met was either still single/unmarried at the ages of 31-35 or already divorced. I recall at least 8-10 tell me they haven't seen their kid in the last weeks to months. Some moved away from the partner/kid to complete fellowship, others say they slept the last 7-1o nights at the hospital. Over half were overweight. I remember only 2-3 people who would pack a lunch (only because their spouse did the cooking and packing as they would tell me). With the rest of them, it was normal for us to show up for 7 am rounds. They hadn't had breakfast. We went down to the OR by 8am, they grabbed a stale donut from the OR lunch room and drank some drip coffee. First OR done at 11ish, we would write the note and they would tell me to take the chance to eat because they had to run up to the ward and check on the post-ops (make sure discharges were being done, notes were done, quick 2-3 min pop into every patient room with the same "things are going well, you're going home tomorrow, see you in follow-up clinic in 4 weeks, any questions? (half list to what to me sounded like legitimate family concerns), the nurse will give you all that info", run out pull out the chart scribble 1-2 lines "looking good, VSS, home tomorrow, follow-up clinic). Run back down to OR, talk to staff about next case, grab a couple of slices of pizza from the OR lunch room, prep next case. Next case done around 3-4pm, run up to ward again, check on morning OR patient on ward or in ICU, check on more complex long term patients. Get a bunch of important questions from the charge nurse on the ward, answer some, defer most to other specialists, complain about other specialists who haven't yet shown up to assess the patient or complain because you disagree with something the other service recommends. Get stopped by rehab staff who tells you a particular patient is not well enough to go home tomorrow. Go see patient and realize they look awful (something we missed in our 1 minute fly-in in the morning), now there's some medical thing we need to fill out for rehab. It's about 5:30pm, we go down to the cafeteria and grab some food, 6pm resident wants to send me home so he can finish notes. I usually decided to stay and read quietly because I wanted to see what the full day holds. 7:30pm we give our handover to the night shift. I'm packing myself up. Resident is staying behind to look over imaging and prep for tomorrow, tells me he'll go home at 9pm. I'm tired and hungry and feel louzy.
I arrive back next day 7am, he's already there and looking over imaging for our case.
During our day the pager is going off at least a dozen times, there are med students who come and go and ask questions, the staff surgeon is drilling the resident with questions during the cases.

As a competitive athlete in college, I remember long hours of training and school. I remember the emphasis placed on nutrition and sleep. Recovery days after competition. Meals prepared for the team after games. Yes, teams in colleges have lots of support. It blows my mind that someone can sustain themselves on a donut and pizza and pop and coffee and be tasked with vital decision making. I do recall errors made in notes that charge nurses would clarify with us. I do recall incidents in which we get flagged by other staff about a patient's complications or need for rehab, which we miss because we literally have 60-90 seconds to check on them. Some people around me think this is some kind of "martyrdom" and "doctor's are special". I completely disagree. I think these residents are over stressed and being used as cheap labour. It takes them so long to prep because they just slow down due to lack of nutrients and sleep. I don't think physiologically it is wise or sustainable to live like this. None of them have time for their own health, let alone fostering personal relationships. When we did have a few minutes in elevators or the cafeteria to just chat about life, they'd ask me how my long weekend was, I would say "oh I went camping with my nephews" and ask them back how their's was "oh I was here" or "had a bunch of reading". I honestly just felt sorry for them. I get it that it's a cool task to be responsible for "Fixing another person", for making them feel better, treating them. I think the way the system is set up is horrible, I think we're creating more sick people. I think more funding and more staffing and more work-life balance would be wiser.

Anyway, just wanted to share my experience. I'm so glad I will be going into DPT instead.
 
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shoal

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They have ZERO personal time and ZERO personal life.

Last year I applied to MD and go rejected. Despite having volunteer and shadow experience, I told myself I would do more and set up some regular shadowing with some specialists. After my rejection, I used a friend connection to spend 2 full days of the week shadowing specialists (in ICU and thoracic surgery) for about 6 months. Since I also had a healthcare background it made it easy to give me access and such to basically attend alll rounds / education activities / surgeries that I wanted.

Prior to this long term experience I thought I had it all figured out and that medicine was my calling. I thought I knew about all the sacrifices MDs make, the long hours, the years of training. It's what I saw every day while working as a hospital assistant. I thought I could make a great doc and really take the time for my patients and care and change the way some doctors deliver care (which I thought was in some ways flawed and attributed to their lack of investment in "really getting to the root of the problem"). Little did I know that even some of those doctors who come across as jerks, really had very good intentions which were destroyed by the state of "medicine" today.

It took this longitudinal experience, which gave me access to the resident meetings, call room conversations, complaints which made me realize this job is actually not what it's made out to be. Many specialists are in it only for the money, and most of those with good intentions are so over worked and so tired and so miserable I actually had a few residents ask me why I ever wanted to go into field. During my 6 months 7/10 of the fellows I met was either still single/unmarried at the ages of 31-35 or already divorced. I recall at least 8-10 tell me they haven't seen their kid in the last weeks to months. Some moved away from the partner/kid to complete fellowship, others say they slept the last 7-1o nights at the hospital. Over half were overweight. I remember only 2-3 people who would pack a lunch (only because their spouse did the cooking and packing as they would tell me). With the rest of them, it was normal for us to show up for 7 am rounds. They hadn't had breakfast. We went down to the OR by 8am, they grabbed a stale donut from the OR lunch room and drank some drip coffee. First OR done at 11ish, we would write the note and they would tell me to take the chance to eat because they had to run up to the ward and check on the post-ops (make sure discharges were being done, notes were done, quick 2-3 min pop into every patient room with the same "things are going well, you're going home tomorrow, see you in follow-up clinic in 4 weeks, any questions? (half list to what to me sounded like legitimate family concerns), the nurse will give you all that info", run out pull out the chart scribble 1-2 lines "looking good, VSS, home tomorrow, follow-up clinic). Run back down to OR, talk to staff about next case, grab a couple of slices of pizza from the OR lunch room, prep next case. Next case done around 3-4pm, run up to ward again, check on morning OR patient on ward or in ICU, check on more complex long term patients. Get a bunch of important questions from the charge nurse on the ward, answer some, defer most to other specialists, complain about other specialists who haven't yet shown up to assess the patient or complain because you disagree with something the other service recommends. Get stopped by rehab staff who tells you a particular patient is not well enough to go home tomorrow. Go see patient and realize they look awful (something we missed in our 1 minute fly-in in the morning), now there's some medical thing we need to fill out for rehab. It's about 5:30pm, we go down to the cafeteria and grab some food, 6pm resident wants to send me home so he can finish notes. I usually decided to stay and read quietly because I wanted to see what the full day holds. 7:30pm we give our handover to the night shift. I'm packing myself up. Resident is staying behind to look over imaging and prep for tomorrow, tells me he'll go home at 9pm. I'm tired and hungry and feel louzy.
I arrive back next day 7am, he's already there and looking over imaging for our case.
During our day the pager is going off at least a dozen times, there are med students who come and go and ask questions, the staff surgeon is drilling the resident with questions during the cases.

As a competitive athlete in college, I remember long hours of training and school. I remember the emphasis placed on nutrition and sleep. Recovery days after competition. Meals prepared for the team after games. Yes, teams in colleges have lots of support. It blows my mind that someone can sustain themselves on a donut and pizza and pop and coffee and be tasked with vital decision making. I do recall errors made in notes that charge nurses would clarify with us. I do recall incidents in which we get flagged by other staff about a patient's complications or need for rehab, which we miss because we literally have 60-90 seconds to check on them. Some people around me think this is some kind of "martyrdom" and "doctor's are special". I completely disagree. I think these residents are over stressed and being used as cheap labour. It takes them so long to prep because they just slow down due to lack of nutrients and sleep. I don't think physiologically it is wise or sustainable to live like this. None of them have time for their own health, let alone fostering personal relationships. When we did have a few minutes in elevators or the cafeteria to just chat about life, they'd ask me how my long weekend was, I would say "oh I went camping with my nephews" and ask them back how their's was "oh I was here" or "had a bunch of reading". I honestly just felt sorry for them. I get it that it's a cool task to be responsible for "Fixing another person", for making them feel better, treating them. I think the way the system is set up is horrible, I think we're creating more sick people. I think more funding and more staffing and more work-life balance would be wiser.

Anyway, just wanted to share my experience. I'm so glad I will be going into DPT instead.
this is a very well written and accurate statement of residency is like. glad you got the experience beforehand.

Sent from my VS986 using Tapatalk
 

IsleyOfTheNorth

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However, the one thing that I do find difficult to grasp is GPs who are themselves overweight and lecture their patience on diet and exercise.
This is why I refuse to be a fat doctor. How can I tell them that their health is important and they need to spend time/effort on it when I obviously don't?
 

QofQuimica

Seriously, dude, I think you're overreacting....
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In case anyone was wondering whether residency sucks....yes, it sucks. :shrug:

For the sake of balance, however, I would point out that one has considerably more flexibility and control over one's lifestyle as an attending. That assumes, of course, that one doesn't go nuts spending every dollar they make as soon as they are awarded their residency completion certificate, and that one is willing to sometimes choose having more free time over having more dollars. Because no one can force you to work 80+ hour weeks as an attending, and "no" is a word that most of us learn by the age of two when someone ostensibly in control of us tries to force us to do something we don't want to do. Revolving one's life around medicine is something that some people choose to do at attendings because of wanting more dollars, career advancement, or other self-imposed reasons. It's not a requirement post-residency.
 
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TheTao

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Doctors often don't have the time to eat properly or work out, particularly during residency, but in some specialties, even beyond. Couple that with the exhausting nature of the work, and the relatively sedentary nature of many fields, and you have a recipe for relatively poor health if one is not careful.
Ensure (it's not just for patients) and stairs (when feasible).
 
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TheTao

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I have made some nonstandard choices to build more activity into my life (such as living close to where I work and walking to work), which I can tell you still gets me some raised eyebrows from the staff, let alone from my physician colleagues, most of whom prefer to live in ritzier areas and commute 20+ miles each way out here. But in my own experience, designing your lifestyle around your health and wealth goals is the only sustainable way to achieve them.
Living closer to work is the best idea I've EVER had, the forced exercise EVERYDAY is where it's at!
 
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esob

esob

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I guess I understand the barriers; long hours, lack of time for exercise, etc. I guess I was more question why the majority of doctors don't choose what a couple of you have already said you do; opted for less pay and other lifestyle variations in order to be healthier, since it seems common sense that the people most educated about health would be the ones most likely to make whatever choices were necessary put their health first.
 

QofQuimica

Seriously, dude, I think you're overreacting....
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I guess I understand the barriers; long hours, lack of time for exercise, etc. I guess I was more question why the majority of doctors don't choose what a couple of you have already said you do; opted for less pay and other lifestyle variations in order to be healthier, since it seems common sense that the people most educated about health would be the ones most likely to make whatever choices were necessary put their health first.
One of the most eye-opening books I ever read was "The Millionaire Next Door" by Thomas Stanley. If you haven't read it, you should. Among other things, most docs aren't good with managing their finances. They overspend and overextend themselves. According to Stanley's research, the average self-made millionaire in this country actually tends to be the guy who owns the local scrap metal yard, laundromat, car dealership, or some other blue collar non-professional venture. Not the kind of guy who has to spend big bucks to dress the part, in other words.
 
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I think it's the fact that most adults start establishing good habits when they start working and getting a comfortable schedule where they figure their life out. For ppl who go into medicine, they spend their prime years getting an education where stress may have them resort to food for comfort. Even those who don't prefer junk food, it becomes very difficult to cook so cheap hopital food, which is ironically unhealthy, becomes the goto.
 
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Hi guys! Upon reading the different reason as to why doctors are not the healthiest professional, to sum it all, the job is most likely very stressful. When stress strikes any unhealthy lifestyle could strongly influence bad habit and can slowly deteriorate doctors' health.
 

Esquire

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Many years ago when I first started working as a lab tech in an army hospital, one of my duties was to assist the pathologist on autopsies. The first one I ever attended featured a lady who had died of a presumed heart attack but for whatever reason, regulations dictated that an autopsy had to be performed. I still remember the crunchy sound her artery (I think it was the carotid) made as the pathologist cut through it looking for the culprit. He found what he described to myself and 2 other young lab techs as "chicken fat" and declared it the perpetrator. We asked what caused it and he offhandedly said it was likely a life well-enjoyed that featured a diet rich in ice cream and other indulgences.

For a long time after that first experience I didn't eat ice cream, assured that the next bowl of blue bell would be the last thing I saw before I ended up the table myself :) Now I know ofc now that one scoop of ice cream isn't a heart attack in a bowl; but I do know that a lifetime of bad habits decreases both quality and quantity of life. It seems then that doctors, more than any other profession, should be acutely aware of this. Thus begs the question, why are docs not all health nuts who have ideal bmi's and live to be 120? Is it just that "once you know" its too overwhelming to try and do everything right or is it something else?
Because when you see disease and death ravage people, sometimes randomly, on a daily basis, that extra scoop of ice cream tastes god damned f'ing good.
 

Nasrudin

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Because Medical Culture is hypocritical, full-of-sh!t, hierarchical nonsense, that doesn't know the first thing about walking a walk, how to motivate themselves or others, and is absent of the idea of manifesting health as opposed pattering about it in abstraction.
 

Entadus

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Because Medical Culture is hypocritical, full-of-sh!t, hierarchical nonsense, that doesn't know the first thing about walking a walk, how to motivate themselves or others, and is absent of the idea of manifesting health as opposed pattering about it in abstraction.
Oooh goodie, it's my favorite SDNer in his natural habitat! Watch how his bitter, blunt, genius, ranting musings twist your lips into a grin like risus sardonicus.

It's true caring for your own health very much becomes an individually-motivated task. Be the change, etc
 

jl lin

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Oooh goodie, it's my favorite SDNer in his natural habitat! Watch how his bitter, blunt, genius, ranting musings twist your lips into a grin like risus sardonicus.

It's true caring for your own health very much becomes an individually-motivated task. Be the change, etc

I gotta say, I think Nas is totally right, by and large, on this one.
 

QofQuimica

Seriously, dude, I think you're overreacting....
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Because Medical Culture is hypocritical, full-of-sh!t, hierarchical nonsense, that doesn't know the first thing about walking a walk, how to motivate themselves or others, and is absent of the idea of manifesting health as opposed pattering about it in abstraction.
Ha. Our whole society is like that; wanting something for nothing is part of the general attitude that permeates every aspect of modern life. It's not like learning about medicine magically changes us into hypocrites. Even before we were medical professionals, we were all part of the larger culture around us, after all. I'd argue that most of us come into this field *already* saying one thing and doing another. It's just that it's far easier for the average 22-year-old to get away with being a hypocrite about their health than it is for the average 42-year-old.
 

Nasrudin

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Ha. Our whole society is like that; wanting something for nothing is part of the general attitude that permeates every aspect of modern life. It's not like learning about medicine magically changes us into hypocrites. Even before we were medical professionals, we were all part of the larger culture around us, after all. I'd argue that most of us come into this field *already* saying one thing and doing another. It's just that it's far easier for the average 22-year-old to get away with being a hypocrite about their health than it is for the average 42-year-old.
Q.....waddup girl. yeah. good point.

And yet i wonder why we're supposed to tell people to be healthy and not one thought has gone into training people that know how to embody health to be able to....idk....maybe a have even a small chance of motivating people.

So yes. But don't you think we should be better at it than the general public. given that is the premise of the transaction....them coming to us to be made more healthy?
 

QofQuimica

Seriously, dude, I think you're overreacting....
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Q.....waddup girl. yeah. good point.

And yet i wonder why we're supposed to tell people to be healthy and not one thought has gone into training people that know how to embody health to be able to....idk....maybe a have even a small chance of motivating people.

So yes. But don't you think we should be better at it than the general public. given that is the premise of the transaction....them coming to us to be made more healthy?
If you hadn't already noticed, people are irrational creatures who make most decisions based upon their primal instincts and emotions, then go back later to rationalize it with a veneer of reason. There are plenty of studies confirming this idea that people believe they are being rational about decisions they made irrationally, even in venues where impassionate decisions based on crunching numbers ought to be possible (say, like playing the stock market). Approaching the goal of understanding people's completely subjective motivations about their health from a rational perspective is a losing proposition.
 

Nasrudin

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If you hadn't already noticed, people are irrational creatures who make most decisions based upon their primal instincts and emotions, then go back later to rationalize it with a veneer of reason. There are plenty of studies confirming this idea that people believe they are being rational about decisions they made irrationally, even in venues where impassionate decisions based on crunching numbers ought to be possible (say, like playing the stock market). Approaching the goal of understanding people's completely subjective motivations about their health from a rational perspective is a losing proposition.

right. but i didn't say anything about rationality.

Quite the opposite. You're exactly right. We're motivated my emotionality/phermones/sex appeal/fear/disgust/sex/power etc. So I'm not saying we should convince someone to be healthy with argument.

I'm saying we should be attractive, healthy, sexy mf'ers our damn selves. And make it look and feel so good being us that why would they not want a piece of the action.

or something more proximal to that....

Q...in all the years you've known me....do you think I'm a proponent of rational argument?

now. hopefully you're shift isn't sucking. and you have time to catch a breath tonight.

stay sexy. ;)
 
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